Rodolfo Tom Dorantes

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA02228 Issued in KY

Practice address

10301 Coneflower LN
Prospect, KY 40059-8355

Phone

(502) 290-6706

NPI assigned

Nov 27, 2023

Last updated

Nov 27, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1740056324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 HARRIS PL",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402226701",
            "telephone_number": "502-649-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10301 CONEFLOWER LN",
            "city": "PROSPECT",
            "state": "KY",
            "postal_code": "400598355",
            "telephone_number": "502-290-6706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORANTES",
        "first_name": "RODOLFO",
        "middle_name": "TOM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "KY",
            "license": "PTA02228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Prospect, KY
• Providers in Prospect, KY by specialty
• Physical Therapy Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.